A History of Medical Reports on the Boston Marathon

INTRODUCTION/METHODS: We performed a systematic search for medical reports on the Boston Marathon, run annually since April 19, 1897 and studied medically since 1899. RESULTS: We identified 66 articles: 25 were related to cardiology; 10, exercise physiology; 8, metabolism; 5, neurology; 4, gastroenterology; 3, hematology; 3, several disciplines; and 8, nephrology, orthopedics, and general topics. The predominance of cardiology articles reflects concerns about the cardiac risks of exercise present in the early 20th century and persistent to this day. The authors and contributors included luminaries from the medical and exercise community including Drs. Paul Dudley White, Samuel Levine, Kenneth Cooper, Paul Zoll, Ellsworth Buskirk, and David Costill. The articles identified or confirmed many of the presently accepted principles of marathon medicine. CONCLUSIONS: Medical studies on the Boston Marathon not only provide lessons applicable to managing modern athletes but also demonstrate the interests and concerns of researchers who have used the event to study the physiology of prolonged exercise for more than a century.